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Page 1: 2012 Application Form E

for 2012 Admissions

Page 2: 2012 Application Form E

1. First-Year Student Application(i) Applicants who possess Language Profi ciency Test Scores A + B(ii) Applicants who don't possess Language Profi ciency Test Scores A + C(iii) Applicants who are native speakers of English or Japanese A Only

2. Transfer Student ApplicationCurrent university students or university graduates who wish to apply to APU as a second-year or third-year transfer student

are obliged to submit additional documents: D Transfer Eligibility Documents

APU Tuition Reduction ScholarshipIn addition to the above documents, applicants who wish to apply for the APU tuition reduction scholarship must submit

E APU Scholarship Application Essay, which is included in the application forms.

See the "Admissions Handbook" for a list of documents which must be submitted with this form.

A Compulsory Documents1. Undergraduate Application Form

2. Academic Transcripts (Most Recent 3 Years)

3. Standardized examination results certifi cates for university entrance (For applicable countries)

4. Application Essay

5. Proof of application fee payment

6. Recommendation Letter

7. Passport Copy (if available)

8. Two Identical Photographs (4cm X 3cm)

B Language Profi ciency Test ScoresEnglish-basis students: TOEFL® (iBT/ PBT)/ IELTS/ TOEIC®*

Japanese-basis students: JLPT/ EJU

* TOEIC® is only applicable for applicants residing in Japan.

C Language Profi ciency Forms・English-basis students: English Profi ciency Evaluation

・Japanese-basis students: Japanese Profi ciency Evaluation (日本語能力認定書)

D Transfer Eligibility Documents1. University Academic Transcripts

2. List of currently-attending classes

3. Credit Requirement for Graduation

4. University Graduation Certifi cate (in case for graduates)

* If you have graduated from university, items 2 and 3 are not required.

E APU Scholarship Application Essay

Admissions Handbooks and Application forms are also available for download at http://admissions.apu.ac.jp

Application Categories

Application Documents

Page 3: 2012 Application Form E

1

FOR UNIVERSITY USE 大学使用欄

受験番号

FOR UNIVERSITY USE 大学使用欄

願 書 受 付 日 □ 推薦 □ 一般

検定料受付日 /    / 検定料納入方法 □ 小切手  □ 海外送金  □ 国内送金  □ CD

A

International StudentsUndergraduate Application FormI. Applicant Information

II. Undergraduate Program of Study

1. Family Name in Alphabet:

2. Given Names in Alphabet:

3. Name in Chinese Characters (if applicable):

4. Date of Birth: Year      Month      Date 5. Gender:  □ Male  □ Female

6. Nationality*: 7. Native Language: □ English  □ Japanese  □ other than English/Japanese* Please confi rm that you and your parents do not possess any form of Japanese nationality.

8. Email: (Please write clearly, as this will be used as the primary contact.)

9. Current Address in Alphabet:

City / State  Country  Postal Code

Address in Chinese Characters (if applicable):

Phone:    Mobile:

10. Mailing Address(if diff erent from above):

City / State  Country  Postal Code

Address in Chinese Characters (if applicable):

Phone:    Mobile:

11: Emergency Contact

Relationship with Applicant □ Father □ Mother □ Others (Please specify)

Name in Alphabet :

Phone:    E-mail:

1. Program Commencement: □ Spring (April) □ Fall (September)

2. Language Basis: □ English □ Japanese

3. Enrollment Status: □ First-Year Student □ Second-Year Transfer □ Third-Year Transfer

4. College Choice*: 1st Choice ( □ College of Asia Pacifi c Studies (APS) □ College of International Management (APM) ) 2nd Choice ( □ College of Asia Pacifi c Studies (APS) □ College of International Management (APM) )* Please check your chosen college(s). A second choice is not mandatory.* Note that there is a possibility that you might not be accepted to your 1st choice of college.

5. Scholarship: Do you wish to apply for APU Tuition Reduction Scholarships? □ Yes □ No □ Apply for scholarship off ered by the other organizations* (details : ) * Please attach the certifi cate.

III. Application Fee

A non-refundable application fee is compulsory for the application. Cash payments will not be accepted.My mode of payment for the application fee is:

□ Bank Transfer (Overseas) Payment Date: Payer’s Name:

□ Bank Transfer (in Japan) Payment Date: Payer’s Name:

□ Bank Check* Bank Name: Check Number:

* Applications will not be evaluated without the application fee.* Payment by bank check is not applicable for applicants residing in Japan.

Please affi x a photograph (4cm X 3cm),

taken within the last 3 months in a plain

background. No cap or hat is allowed.

Page 4: 2012 Application Form E

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IV. Education History

V. Employment HistoryIf you are currently working or have been employed previously, please complete details below and attached a Letter of Employment from the company. Part-time work must not be included.

Company Name   Company Address   Started (yy/mm)   Completed (yy/mm)  Responsibilities

           

           

VIII. Declaration and SignatureI understand that the University may vary or cancel any decision if any incorrect or incomplete information is given; Submitted documents for this application become the property of the University and will not be returned to me.I hereby declare that all information provided is true and correct.

In chronological order, please list all schools in English, that you have attended from elementary school to the last or current-attending school. (Nursery, kindergarten and language schools are not to be included.) Please write the school name in English.Please note that 12 years of offi cial education (or scheduled completion) is required for fi rst-year student applications.

Institution Name   City/ Country   Started (yy/mm)   Completed (yy/mm)   Course/ Award

           

           

           

           

           

The Institution Name where you completed (or are scheduled to complete) the 12 years of offi cial education :

If you have attended other schools e.g. language schools and specialized institutions, please write details below.Institution Name   City/ Country   Started (yy/mm)   Completed (yy/mm)   Course/ Award

           

           

Date: Applicant’s Signature:

VI. Language Profi ciencyIf you have taken any language profi ciency tests in the list below, please fi ll in your test details and attach the original score report with your application. Photocopies or certifi ed copies of the test score reports will not be accepted.

Test Name Test Date (Month, Year)   Test Score

Registration ID: TOEFL® (iBT/ PBT)          

 Test Report Form Number: IELTS               

TOEIC®*  

JLPT  

EJU  

* TOEIC® is only applicable for applicants residing in Japan.・Test results are valid for two years from the date of the test. ・TOEFL®, IELTS and TOEIC®: Please request the test center to send the score reports to APU directly. The institution code of APU is 2791.

VII. Documents to be returnedPlease note that the University will only return upon request original documents that cannot be reissued.

I request for document(s) to be returned□ No □ Yes   Name(s) of document:

Page 5: 2012 Application Form E

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Please answer the following short essay questions in legible characters personally. Both handwritten and typed essay will be accepted. The length of each essay should be approximately 300 words. Please include the word count at the end of each answer.

Application EssayName Nationality

1. Please write the reason/s why you wish to study in APU.

( words)

2. Please write the reason/s why you choose APS/APM as your fi rst choice of college.

( words)

A

Page 6: 2012 Application Form E

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Date: Signature:

3. Please write about any commendable experiences that you have.

( words)

4. What are your plans after graduating from APU? How do you plan to contribute to the international society?

( words)

Page 7: 2012 Application Form E

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Instructions for the applicant ‒ Complete part 1 and submit this form to your recommender. If possible, the recommender should have known you for at least a year or more. The recommender may either return the recommendation to you in a sealed envelope, or mail it to us separately.

Recommendation Letter

PART 1 To be completed by applicant

PART 2 To be completed by recommender

PART 3 To be completed by recommender. You may use the space below or enclose a separate letter.

Name, as given on the application

School Name:

Choice of College:    College of Asia Pacifi c Studies (APS)      College of International Management (APM)

Instructions for the recommender ‒ Complete parts 2 and 3. Your appraisal of the applicant’s qualities and potential to carry out studies at the undergraduate level will help us evaluate the applicant more fairly. Please either write your comments in the space provided or enclose a separate letter of reference. Please enclose this form and any separate sheets in a sealed envelope, and write your signature over the sealed fl ap. You may then either return the sealed envelope to the student, or mail it to us at: Ritsumeikan Asia Pacifi c University, Admissions Offi ce (International), 1-1 Jumonjibaru, Beppu, Oita, 874-8577 Japan.

Name: Occupation:

Name of Organization/ Institution:

Address:

Contact Number: Email:

What is your relationship with the applicant? □ Professor/ Teacher □ Employer/ Supervisor □ Others( )

How long have you known the applicant? □ More than 2 years □ 1 to 2 years □ Less than a year

Letter of ReferencePlease write about the applicant’s qualities, and we would like your views on the applicant’s intellectual and academic abilities. Any personal circumstances, unusual accomplishments or obstacles overcome that make this applicant stand out from his peers should also be mentioned.

Date: Signature:

A

Page 8: 2012 Application Form E

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志願者へ ‒ Part 1 を記入し、あなたの推薦者に渡してください。可能であれば、最低 1年以上あなたを指導した教員に依頼してください。推薦者には厳封を依頼して直接あなたに手渡すか、アドミッションズ・オフィスに直送してもらってください。

推 薦 書

PART 1 志願者記入欄

PART 2 推薦者記入欄

PART 3 推薦者記入欄 別紙に記入し、添付していただいてもかまいません。

志願者氏名

学校名

志望学部    アジア太平洋学部         国際経営学部

推薦者へ ‒ Part 2 と Part 3 にご記入ください。公平な入学審査を行うため、学士課程に留学するにあたっての志願者の資質および将来性について評価してください。評価は別紙に記入し、添付していただいても結構です。記入後は全ての書類を厳封し志願者に渡すか、アドミッションズ・オフィスに直送してください。書類送付先: 立命館アジア太平洋大学 アドミッションズ・オフィス(国際) 〒 874-8577 日本国大分県別府市十文字原 1丁目 1番

推薦者氏名 職業

所属機関名

所属機関住所

連絡先電話番号 Email

あなたは志願者とどのような関係ですか。 □ 教授・先生 □ 事業主・上司 □ その他( )

あなたは志願者をどのぐらい知っていますか。 □ 2年以上 □ 1年~2年間 □ 1年未満

推薦書志願者の資質、学識、学力についての評価をお願いします。特に優れた実績や障害の克服など、特筆すべき志願者のエピソードがあればご紹介ください。

日付 署名

A

Page 9: 2012 Application Form E

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Instructions for the applicant ‒ Complete part 1 and submit this form to your teacher. If possible, the teacher should have taught you for at least a year or more. The teacher may either return this form to you in a sealed envelope, or mail it to us separately.

English Profi ciency Evaluation

PART 1 To be completed by applicant

C

Time period that you have taught the applicant     / ― /yy / mm yy / mm

Please write your comments about the applicant’s language abilities.

Excellent(600<TOEFL)

Good(600<TOEFL<550)

Average (550<TOEFL<500)

Below Average(TOEFL<500)

Speaking □ □ □ □

Listening □ □ □ □

Writing □ □ □ □

Reading □ □ □ □

Name, as given on the application:

School Name:

Choice of College:    College of Asia Pacifi c Studies (APS)      College of International Management (APM)

Instructions for the evaluator ‒ Complete parts 2 and 3. You should be an individual in the fi eld of English language education. Please assess the language profi ciency of the applicant objectively by checking the below chart, and completing the comments in the provided space in view of his/ her ability for university classes. Please enclose this form in a sealed envelope, and write your signature over the sealed fl ap. You may then either return the sealed envelope to the student, or mail it to us at: Ritsumeikan Asia Pacifi c University, Admissions Offi ce (International), 1-1 Jumonjibaru, Beppu, Oita, 874-8577 Japan.

PART 2 To be completed by evaluator

PART 3 To be completed by evaluator

Name: Occupation:

Name of Organization/ Institution:

Address:

Contact Number: Email:

Date: Signature:

Page 10: 2012 Application Form E

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志願者へ ‒ Part 1を記入し、あなたの日本語指導教員に渡してください。可能であれば、最低1年以上あなたを指導した教員に依頼してください。認定者には厳封を依頼して直接あなたに手渡すか、アドミッションズ・オフィスに直送してもらってください。

日本語能力認定書

PART 1 志願者記入欄

C

志願者を指導した期間           / ― /年  /  月 年  /  月

志願者の言語能力についてご意見を聞かせてください。

優(320<JLPT1級)

良(280<JLPT1級320)(320<JLPT2級)

可(240<JLPT1級280)(280<JLPT2級320)

不可(JLPT2級280)

話す力 □ □ □ □

聞く力 □ □ □ □

書く力 □ □ □ □

読む力 □ □ □ □

志願者氏名

学校名

志望学部     アジア太平洋学部         国際経営学部

認定者の方へ ‒ Part 2 と Part 3 にご記入ください。 認定者は、日本語教育に携わる教員に限ります。下記の表とスペースを使い、大学の授業を受けるための言語能力という観点から、志願者の言語能力を正確かつ厳密に査定し記入してください。記入後は厳封し志願者に渡すか、アドミッションズ・オフィスに直送してください。書類送付先: 立命館アジア太平洋大学 アドミッションズ・オフィス(国際) 〒 874-8577 日本国大分県別府市十文字原 1丁目 1番

PART 2 認定者記入欄

PART 3 認定者記入欄

認定者氏名 職業

所属機関名

所属機関住所

連絡先電話番号 Email

日付 署名

Page 11: 2012 Application Form E

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Please note that only students who will obtain the “College Student” visa before admissions are eligible to apply for the APU tuition reduction scholarship at the time of application. This scholarship is made available by the fi nancial contributions of domestic and international companies and individuals, with the Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT) that support the ideals of APU, and its purpose is to help reduce the fi nancial burden for outstanding international students. Students awarded with this scholarship are expected to serve as role models. Based on the above intentions, individuals who would like to apply for the APU tuition reduction scholarship must answer the following 2 questions in details. The length of each essay should be approximately 300 words.* Both handwritten and typed essay will be accepted. Please include the word count at the end of each answer.

APU Scholarship Application

Name Nationality

1. How well do you intend to perform academically as an APU scholarship recipient?

( words)

E

Page 12: 2012 Application Form E

2. What kind of student life do you plan to lead as a scholarship student at APU?

( words)

Date: Signature:

Page 13: 2012 Application Form E

employment rate

Please check within the provided boxes.

Example

Page 14: 2012 Application Form E

Personal Information PolicyPersonal information collected from individuals during the admissions process will be handled in accordance with the following.(1) Purpose of Use of personal Information① To carry out the admissions process, such as screening, etc.② To notify results③ To send enrollment-related documents④ To complete the procedures to attain the Certifi cate of Eligibility to issue a VISA⑤ To send the orientation guide for new students⑥ To send various questionnaires after admission

(2) Management of Personal Information  Ritsumeikan Asia Pacifi c University will manage the personal information of application in compliance

with relevant laws and regulations. Information will be managed securely to prevent loss, destruction or divulgence.

(3) Outsourcing of Handling of Personal Information  Ritsumeikan Asia Pacifi c University may outsource part of the handling of the personal information of

applicants when necessary, such as the receipt of applications or the data entry of personal details. In such cases, Ritsumaikan Asia Pacifi c University and the external organization will sign a contract regarding the appropriate management of personal information.

(4) Statistical Use of Personal Information  Ritsumeikan Asia Pacifi c University may use data extracted from applicants’ personal information to

conduct various statistical analysis to be used for surveys and research relating to the admission process. This data may also be provided to students interested in applying to Ritsumaikan Asia Pacifi c University. However, the university shall ensure that any information made public cannot be used to identify specifi c individuals.